Category Archives: LIVING WITH DIABETES

For an individual with either type-1 or type-2 diabetes, the threat of hypoglycemia — commonly known as low blood glucose — is constant. Blood-sugar levels that drop too low present a variety of health risks, and exercise can cause blood-glucose levels to drop in both diabetics and those without diabetes. When exercising, it’s important to understand the relationship between physical activity, food intake and hypoglycemia.

Diabetes and Blood Sugar

Individuals with type-1 and type-2 diabetes, also respectively known as juvenile diabetes and adult onset diabetes, must closely monitor their blood glucose levels. Blood sugar that is too high can cause behavioral changes and result in long-term damage to the body, while low blood sugar can cause immediate danger; if not raised with a fast-acting glucose, such as fruit juice, low blood sugar may cause a seizure or coma. Diabetics need to take care when exercising, as physical activity can lead to a rapid decline in blood-glucose levels.

Eating and Exercise

When exercising, your body burns the fuel you’ve taken in from food, especially the carbohydrates that have been converted into blood glucose. When exercising, it’s important to ensure you’ve provided your body with enough fuel to accommodate the level of exercise you’ll be doing to prevent blood sugar from dropping to a dangerously low level . For this reason, if you haven’t had a hearty, well-balanced meal before an intense workout, it’s necessary to have a carbohydrate-rich snack that will provide you with enough energy to carry you through your work out.

Hypoglycemia

Hypoglycemia takes place when your blood glucose drops lower than normal. Eventhough this typically occurs in a diabetic who has administered too much insulin in relation to the amount of carbohydrates ingested, this can also occur in those who don’t have diabetes and exercise on an empty stomach. Among the symptoms of hypoglycemia are headache, excessive perspiration, elevated heart rate, blurred vision, shakiness, mental confusion and irritability. When blood glucose levels drop to dangerously low levels, symptoms can include slurred speech, seizures, fatigue and, eventually, coma. Because early symptoms such as sweating and a faster heart rate can also be attributed to exercise, the easiest way to prevent hypoglycemia is to eat a healthy meal or snack before exercising.

Carbohydrates

Remember, it’s possible that eating carbohydrates immediately before exercising may lead to a condition known as rebound hypoglycemia. AKA the Somogyi Effect, rebound hypoglycemia occurs when your blood glucose drops rapidly and becomes low enough to cause your body to release a hormone called glucagon, which raises blood sugar. This sudden rise in blood sugar will usually result in the activation of stress hormones that will keep blood-glucose levels elevated for a sustained period of time, often accompanied by symptoms that are similar to those of hypoglycemia. The advice to avoid eating carbohydrates between 30 and 60 minutes before exercising are “unfounded.” But, researchers concluded that exercisers may experience symptoms similar to those of hypoglycemia, but these are usually not linked to low blood glucose levels or exercise performance. Rather, reduced exercise performance due to eating carbohydrates right before a workout is “minimal,” and may even improve performance.

Insulin is a hormone. It makes our body’s cells absorb glucose from the blood. The glucose is stored in the liver and muscle as glycogen and stops the body from using fat as a source of energy.

When there is very little insulin in the blood or none at all, glucose is not taken up by most body cells. When this happens our body uses fat as a source of energy. Insulin is also a control signal to other body systems, such as amino acid uptake by body cells. Insulin is not identical in all animals – their levels of strength vary.

Porcine insulin, insulin from a pig, is the most similar to human insulin. Humans can receive animal insulin. However, genetic engineering has allowed us to synthetically produce ‘human’ insulin.

The pancreas

The pancreas is part of the digestive system. It is located high up in your abdomen and lies across your body where the ribs meet at the bottom. It is shaped like a leaf and is about six inches long. The wide end is called the head while the narrower end is called the tail; the mid-part is called the body.

The pancreas has two principal functions:

It produces pancreatic digestive juices.

It produces insulin and other digestive hormones.

The endocrine pancreas is the part of the pancreas that produces insulin and other hormones.

The exocrine pancreas is the part of the pancreas that produces digestive juices.

Insulin is produced in the pancreas. When protein is ingested insulin is released.

Insulin is also released when glucose is present in the blood. After eating carbohydrates, blood glucose levels rise.

Insulin makes it possible for glucose to enter our body’s cells – without glucose in our cells they would not be able to function. Without insulin the glucose cannot enter our cells.

Within the pancreas, the Islets of Langerhans contain Beta cells, which synthesize (make) the insulin. Approximately 1 to 3 million Islets of Langerhans make up the endocrine part of the pancreas (mainly the exocrine gland), representing just one fiftieth of the pancreas’ total mass.

Etymology (history) of the word pancreas

It is said that the pancreas was described first by Herophilus of Chalcedon in about 300B.C. and the organ was named by Rufus of Ephesus in about 100A.D

However, it is an established fact that the word pancreas had been used by Aristotle (384-322B.C.) before Herophilus.

In Aristotle’s Historia Animalium, there is a line saying “another to the so-called pancreas”. It is considered that the words “so-called pancreas” imply that the word pancreas had been popular at the time of Aristotle, but it had not been authorized yet as an anatomical term.

However, the word pancreas presumably has been accepted as an anatomical term since Herophilus.

The word pancreas comes from the Greek pankreas, meaning sweetbread.How the Body Works: The Pancreas

Irving A. Cohen, MD, MPH, will be at Book Expo America 2009, Booth 5065, May 29-31, to discuss his new book “Dr. Cohen’s Guide to the New Hippocratic DietTM: How to Really Lose Weight and Beat the Obesity Epidemic” It teaches dieters how to lose weight easily and naturally despite having failed before.

In his book, Dr. Cohen explains how three decades ago the Federal government tried to “fix” the problem of overweight adults by recommending low-fat diets for all Americans. They were wrong. As a result, four times as many Americans are overweight. Because most Americans believe that bad advice, they gain weight as they try to diet. The government blocks efforts to help those who are overweight or who may suffer from Type 2 Diabetes, unless they conform to that misguided government policy.

Dr. Cohen’s weight-loss program has helped many. In addition to losing weight, people suffering from Type 2 Diabetes have been able to come completely off medications and reverse their disease. His book has been featured on The Diabetes Power Show. Dr. Cohen developed his approach using a mathematical model (Medical Hypotheses, in press, http://dx.doi.org/10.1016/j.mehy.2009.03.039) that predicts the ability of a weight reduction of diet to suppress hunger. That model showed that diets are not equal, and the approach pushed by the government increases hunger, causing dieters to fail.

The book explains how Dr. Cohen studied older medical practices as a Fellow in the History of Medicine to find similarities to the approach he was using. He found parallels both in 19th century Germany as well as 2400 year old recommendations of Hippocrates, the founder of rational Western medicine. The book offers practical, modern advice on how to use weight naturally, as was done in times past.

Dr. Cohen is a Board-Certified physician specializing in Preventive Medicine and a Fellow of the American College of Preventive Medicine. He trained in Preventive Medicine at Johns Hopkins University where he served as Chief Resident of Preventive Medicine. He has served as the Deputy Director of the New York State Research Institute on Addictions. He now practices in Kansas.

Type 2 diabetes is a syndrome characterized by high blood sugar resulting from an impaired response to insulin. Type 2 diabetes is usually diagnosed in patients over the age of thirty, but it also occurs in children and teens. It is commonly associated with being overweight, especially around the abdomen area. Many times, it is diagnosed after a period of significant weight gain.

Type 2 diabetes is diagnosed when the criteria for fasting high blood sugar are met. Blood sugar level is greater than or equal to 140 mg/dL (7.77 mmol/L) after an overnight fast on two occasions, or the American Diabetes Association criteria of fasting blood sugar greater than 126 mg/L (6.99 mmol/L) can considered to be diagnostic.

A test called the oral glucose tolerance test is often conducted if fasting blood sugar is between 115 and 140 mg/dL (6.38 and 7.77 mmol/L) and in those with a clinical condition that might be related to undiagnosed type 2 diabetes.

For monitoring diabetes, glycosylated hemoglobin (HbA1c) is tested to estimate blood sugar control over the prior three months.

Natural Treatments for Diabetes

Most people with this type of diabetes are treated with diet, exercise and oral prescription drugs. Some people require the use of insulin to control blood sugar. Several alternative methods may help when used under medical supervision in conjunction with standard treatments. Once herbs and other measures for controlling blood sugar work, medication needs to be adjusted by your doctor.

Diet
A balanced diet is recommended. Foods that emphasize vegetables, legumes, whole grains, and fiber can influence the release of sugar into the bloodstream. Foods that should be avoided are refined sugar, processed food, junk food, pastries, and cookies. When checking labels, watch out for hidden forms of sugar, such as dextrose, glucose, sucrose, corn sweeteners, fructose, dextrin, high-fructose corn syrup, lactose, modified cornstarch, maltose, malt, fruit juice concentrates, mannitol, sorghum, xylitol, and sorbitol. Protein snacks should be eaten in between meals. Alcohol, tobacco, and caffeine should be avoided.

All foods cause a varying insulin response in our bodies. Foods that have a higher rating on the “glycemic index”, a scale developed by nutrition researchers at the University of Toronto, cause a higher insulin spike than those with a lower rating.

Herbs, Nutritional Supplements and Vitamins
Chromium – Chromium is an essential trace mineral. It plays a major role in sugar metabolism. There is a growing body of evidence that shows that chromium may help bring blood sugar levels under control in type 2 diabetes. A typical dose of chromium for diabetes is 200 to 400 mcg per day.

Fenugreek – Fenugreek is a spice commonly used in India and the Middle East in cooking. Numerous studies suggest that fenugreek can reduce blood sugar and cholesterol levels in people with diabetes. Fenugreek seeds can have a bitter taste, so people sometimes prefer to take it in capsule form. A typical dose range is 5 to 30 g three times per day with meals. Known side effects of high doses include mild digestive distress. Fenugreek should not be used by pregnant or nursing women.

Gymnema – Gymnema is an Ayurvedic herb that is believed to have a marked effect on blood sugar control. Doctors often prescribe gymnema for mild cases of type 2 diabetes, in conjunction with standard treatments. A typical dose range is 400 to 600 mg per day of an extract standardized to contain 24% gymnemic acids.

Vanadium – Vanadium is an essential trace mineral that may mimic insulin to help regulate blood sugar. It is found in black pepper, dill seed, and unsaturated vegetable oil, as well as in vitamin supplements.

Other herbs and supplements – The function if the digestive organs should be optimized, particularly the liver and pancreas. Dandelion and other bitter herbs, tumeric, and bupleurum are just a few of the herbs that can help with this. Another goal should be to tonify the endocrine system and promote hormonal balance. Ginseng, licorice, oatstraw, and hawthorn are some of the herbs that can tonify the endocrine system.

Lipoic acid – In Germany, the antioxidant lipoic acid is used widely for the prevention and treatment of peripheral neuropathy in diabetes. This complication usually develops after many years, and is a painful condition affecting the nerves. Lipoic acid occurs naturally in the body, and it is often reduced in people with diabetes. It is involved in the energy metabolism in the body. There is some evidence that lipoic acid may be more effective if it is combined with GLA (gamma-linolenic acid). A typical dose for diabetes is 300 to 600 mg per day, divided into two or three doses.

GLA (Gamma-Linolenic Acid) – An excellent source of the essential fatty acid is evening primrose oil. It is also found in black currant and borage oil. There is some research suggesting that evening primrose oil can protect nerves, and help with symptoms such as pain and numbness. A typical dosage is 4 to 6 g daily, taken with food. Evening primrose oil requires about six months to have noticeable effect. One caution, it is possible that GLA may worsen temporal lobe epilepsy.

Omega-6 oils should be taken in balance with omega-3 oils, found in flaxseed oil, pumpkin seeds, walnuts, and fish oil. Omega-3 fats can help protect blood vessels and decrease insulin resistance.